| NPI | 1063145902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 905175) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 905175) |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2024-05-13 |