| NPI | 1376068759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 56461) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 56461) |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2022-04-19 |