| NPI | 1477132660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 70090) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2021017645) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2022-09-29 |