| NPI | 1174177612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MS 904173) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 906553) |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2023-03-20 |