| NPI | 1093729725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 20381) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 002816) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 269988) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-11-09 |