| NPI | 1245836303 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11010536) | 
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: FL 9203568) | 
| Enumeration Date | 2020-12-04 | 
| Last Update Date | 2021-04-02 |