| NPI | 1174296057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL 944-4832) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11016959) |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2023-04-20 |