| NPI | 1457697567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 739382) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 22052) |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2022-03-03 |