| NPI | 1700196839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9228624) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 202203453NP-PP) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1076164) | |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2023-01-05 |