| NPI | 1619513793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 223700) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN154425) |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2022-01-25 |