| NPI | 1205430410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 67228) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 1628612) |
| 163W00000X Registered Nurse (Licence: OR 201506784) | |
| Enumeration Date | 2020-11-28 |
| Last Update Date | 2023-03-06 |