| NPI | 1487623179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID F0703081) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID N23882) |
| 363L00000X Nurse Practitioner (Licence: ID NP610) | |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2024-05-20 |