| NPI | 1316316029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5012866) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001219325) |
| 163WE0003X Registered Nurse Emergency (Licence: NC 262991) | |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2020-03-10 |