| NPI | 1043803547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL f10201502) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 2626992) |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2021-02-16 |