| NPI | 1194082495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5005571) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024172658) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2022-04-29 |