| NPI | 1417413238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-162691) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-162691) |
| Enumeration Date | 2019-02-17 |
| Last Update Date | 2020-10-14 |