| NPI | 1053023697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 202212478RN) |
| Additional Taxonomies | 363LS0200X Nurse Practitioner, School (Licence: OR 202212478RN) |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2022-12-14 |