| NPI | 1861163990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11015640) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN9467045) |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2021-09-28 |