| NPI | 1497275721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009641) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 297385) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2022-01-07 |