| NPI | 1972238772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA 167978) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA 167978) |
| Enumeration Date | 2022-07-18 |
| Last Update Date | 2022-08-26 |