| NPI | 1316465867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS 903599) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 903599) |
| 363LF0000X Nurse Practitioner Family (Licence: CO 0000853-C-NP) | |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2020-07-30 |