| NPI | 1508517061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 53281) |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy (Licence: ID 531281) |
| Enumeration Date | 2022-01-15 |
| Last Update Date | 2025-01-30 |