| NPI | 1205418712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11009546) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11009546) |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2021-06-27 |