| NPI | 1699235390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5011701) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC AG01190170) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2023-01-03 |