| NPI | 1306189303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 22705) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: SC 200172) |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2020-03-02 |