| NPI | 1811515224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5013332) |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2020-09-10 |