| NPI | 1063154813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MD R215369) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD 2021085909) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-04-12 |