| NPI | 1891489183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2023011557) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2023011557) |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2023-07-14 |