| NPI | 1679219588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 905326) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MS 905326) |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2023-04-04 |