| NPI | 1003564014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11018902) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95020371) |
| 363L00000X Nurse Practitioner (Licence: AZ 247800) | |
| 363L00000X Nurse Practitioner (Licence: NV 855699) | |
| Enumeration Date | 2022-03-17 |
| Last Update Date | 2024-09-06 |