| NPI | 1629693460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 25486) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 284480) |
| 363L00000X Nurse Practitioner (Licence: NC 5013277) | |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2021-11-03 |