| NPI | 1790395101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 24129) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 2924129) |
| Enumeration Date | 2020-08-01 |
| Last Update Date | 2023-07-17 |