| NPI | 1053641571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5005027) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5005027) |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2025-02-05 |