| NPI | 1063174605 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MS 906335)  | 
| Additional Taxonomies | 163WX0800X Registered Nurse, Orthopedic (Licence: MS 909612)  | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MS 906335)  | |
| Enumeration Date | 2021-10-11 | 
| Last Update Date | 2023-10-25 |