| NPI | 1588932461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 306702) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: RI APRN03226) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4284) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP61531839) | |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2025-12-30 |