| NPI | 1700583192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5018626) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 272013) |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2023-09-13 |