| NPI | 1083010318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: LA 04576) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP07580) |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2021-11-18 |