| NPI | 1023772894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 374366) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA 701985) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP028613) | |
| Enumeration Date | 2021-10-27 |
| Last Update Date | 2024-12-09 |