| NPI | 1578062048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 57869) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175932) |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2020-09-09 |