| NPI | 1134716483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA a163422) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 107660) |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2021-05-05 |