| NPI | 1720754674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-155978) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AL 1-155978) |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2024-05-16 |