| NPI | 1558764381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 2619582) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 2619582) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2021-03-12 |