| NPI | 1447807805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 903379) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA 205062) |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2021-09-15 |