| NPI | 1588919351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A089231) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA 089231) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2022-02-04 |