| NPI | 1861086753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NC 5014662) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: SC 25300) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5014662) | |
| 163W00000X Registered Nurse (Licence: SC 103474) | |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2026-06-04 |