| NPI | 1063197408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5018473) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 271039) |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2024-03-03 |