| NPI | 1376210492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: NC 5015250) |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2021-11-08 |