| NPI | 1962128108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-180393) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-180393) |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2024-10-03 |