| NPI | 1689275349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5021258) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: WI 20-435) |
| 363L00000X Nurse Practitioner (Licence: FL 11030383) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11030383) | |
| Enumeration Date | 2020-11-07 |
| Last Update Date | 2025-01-10 |