| NPI | 1346793502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009003) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 245528) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5009003) | |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2022-08-26 |