| NPI | 1184123630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 21614) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 21614) |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2020-11-10 |