| NPI | 1144888496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WY 44541) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 839186) |
| Enumeration Date | 2019-06-02 |
| Last Update Date | 2020-02-13 |