| NPI | 1780241182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 22895) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 231836) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2022-07-22 |