| NPI | 1992349831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1145202) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-145202) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: AL 1-145202) | |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2023-06-28 |