| NPI | 1114680311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5016208) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 25145) |
| Enumeration Date | 2021-10-15 |
| Last Update Date | 2022-05-31 |