| NPI | 1255968103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 30580) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 177041) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2021-12-27 |