| NPI | 1073178133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 73671) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 73671) |
| Enumeration Date | 2019-05-04 |
| Last Update Date | 2023-06-30 |