| NPI | 1699551119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5018732) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 5018732) |
| Enumeration Date | 2023-09-01 |
| Last Update Date | 2023-10-04 |