| NPI | 1104455823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: VA 0001195004) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024183201) |
| Enumeration Date | 2020-04-04 |
| Last Update Date | 2022-02-18 |