| NPI | 1124798053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP022593) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA MK7819088) |
| 163W00000X Registered Nurse (Licence: PA RN660162) | |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2025-03-06 |