| NPI | 1215200498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 111363) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A-116917) |
| Enumeration Date | 2012-02-17 |
| Last Update Date | 2023-01-24 |