| NPI | 1508628678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11011782) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA 61526857) |
| Enumeration Date | 2024-01-25 |
| Last Update Date | 2024-04-26 |