| NPI | 1225636848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5017733) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 296250) |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2023-05-02 |