| NPI | 1245904663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP024804) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN627140) |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2024-02-18 |