| NPI | 1629613328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: AL 1-155257) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-155257) |
| Enumeration Date | 2019-11-17 |
| Last Update Date | 2023-03-27 |