| NPI | 1255880621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IA A160254) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SD CP001257) |
| 363LF0000X Nurse Practitioner Family (Licence: MN CNP 4821) | |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2024-09-18 |