| NPI | 1003465279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 2019033358) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-130154) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: AL 2019033356) | |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |