| NPI | 1508614397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 115456) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 81706) |
| 363LF0000X Nurse Practitioner, Family (Licence: NE 115456) | |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2024-09-30 |