| NPI | 1164262101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 209513) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: LA 209513) |
| 163WC0200X Registered Nurse Critical Care Medicine (Licence: LA 209513) | |
| Enumeration Date | 2024-05-28 |
| Last Update Date | 2024-05-28 |