| NPI | 1316416555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5017016) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 22402) |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2022-12-21 |