| NPI | 1376310441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5019255) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 405545) |
| Enumeration Date | 2023-12-07 |
| Last Update Date | 2024-07-26 |