| NPI | 1902405962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: PA SP023799) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: VA 0024180362) |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2023-04-13 |