| NPI | 1639912157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5020376) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 311136) |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-10-30 |