| NPI | 1104557735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: LA 226156) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA 226156) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2023-11-15 |