| NPI | 1083952030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 25603) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 102389) |
| 171M00000X Case Manager/Care Coordinator (Licence: SC 4208138) | |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 102389) | |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2022-11-08 |