| NPI | 1215543947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11006604) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: FL 9273018) |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2021-12-16 |