| NPI | 1912527896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AL 1-173672) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-173672) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2021-12-16 |