| NPI | 1922606136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11007040) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PR 3729PA) |
| 163W00000X Registered Nurse (Licence: PR G084498) | |
| 164W00000X Licensed Practical Nurse (Licence: FL PN5199917) | |
| 163W00000X Registered Nurse (Licence: FL RN9548013) | |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2024-04-15 |