| NPI | 1255750626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011443) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 261954) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2019-03-14 |