| NPI | 1588653828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP466A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 7620743-4405) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2022-12-12 |