| NPI | 1548885866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV 828322) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: NV 828322) |
| 207Q00000X Family Medicine (Licence: NV 828322) | |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2020-10-16 |