| NPI | 1669126777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 1-159667) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA 1-159667) |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2023-09-13 |