| NPI | 1194237743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP67517) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AK 125599) |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2021-04-20 |