| NPI | 1477012029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A175030) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 112732) |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2023-08-25 |