| NPI | 1295736148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN9495268) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 112246-030) |
| 363L00000X Nurse Practitioner (Licence: WI 2316-033) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2019-03-20 |