| NPI | 1023671070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011811) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC RUI71R) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2020-10-08 |