| NPI | 1508121187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5005692) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 132821) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2020-01-08 |