| NPI | 1164017612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-155862) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-155862) |
| Enumeration Date | 2021-03-06 |
| Last Update Date | 2024-07-15 |