| NPI | 1750154704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP028573) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA SP028573) |
| Enumeration Date | 2023-11-01 |
| Last Update Date | 2024-02-06 |