| NPI | 1558808501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ID 55656) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A106999) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2021-09-15 |