| NPI | 1417661364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 34020) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 916915) |
| 363LF0000X Nurse Practitioner Family (Licence: AL 3-001163) | |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2023-11-11 |