| NPI | 1407063282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5003012) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5003012) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 3106) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2023-08-04 |