| NPI | 1619226032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R878663) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R878663) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2021-12-13 |