| NPI | 1154705788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007792) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 239984) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2024-02-21 |