| NPI | 1497100580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 212553) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 6211903-4405) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2020-08-12 |