| NPI | 1093364119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013255) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC CARR-0WUEJM) |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2024-07-10 |