| NPI | 1053610170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5017820) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017820) |
| 163W00000X Registered Nurse (Licence: NC 233571) | |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2024-02-14 |