| NPI | 1295512010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11028664) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9441425) |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2024-03-15 |