| NPI | 1023752417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 36258) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-171613) |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2024-07-15 |