| NPI | 1720601297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 10176-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 177650-30) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 10176-33) | |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2021-11-18 |