| NPI | 1205225836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 69682) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OR 201601980NP-PP) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2022-03-02 |