| NPI | 1356011373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015093) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC MCCU-KY9FI) |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2023-10-23 |