| NPI | 1417570482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9720) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 9720-33) |
| Enumeration Date | 2020-05-25 |
| Last Update Date | 2021-12-01 |