| NPI | 1245994839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 25657) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC AG10210066) |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2022-01-11 |