| NPI | 1306450119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5013465) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 5013465) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5013465) | |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2022-03-02 |