| NPI | 1790469823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 73995) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM N-89561) |
| Enumeration Date | 2023-06-09 |
| Last Update Date | 2023-06-26 |