| NPI | 1174168744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD r176488) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R176488) |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2022-09-08 |