| NPI | 1710458062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 66812) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 220060) |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2023-02-10 |