| NPI | 1518202175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 66771-CNP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM cnp02119) |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2024-12-26 |