| NPI | 1215422951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014592) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM CNP-03470) |
| 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-03470) | |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2024-03-06 |