| NPI | 1730758251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-126912) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-126912) |
| Enumeration Date | 2021-06-19 |
| Last Update Date | 2021-12-09 |