| NPI | 1205215043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11012734) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9406460) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2022-05-31 |