| NPI | 1184276735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: LA 207909) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN136138) |
| Enumeration Date | 2019-07-14 |
| Last Update Date | 2021-01-20 |