| NPI | 1558767046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011232) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9324695) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2019-01-03 |