| NPI | 1679311120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP030164) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN596907) |
| Enumeration Date | 2024-07-18 |
| Last Update Date | 2025-02-17 |