| NPI | 1194017624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 608) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP3999) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2021-02-17 |