| NPI | 1225408875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC LIST-74JCUA) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2303999) |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2023-03-13 |