| NPI | 1992425912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11020876) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9515914) |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2022-08-30 |