| NPI | 1972163210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 11003096) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11003096) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2020-12-24 |