| NPI | 1619953593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP1097) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS RN091177) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2021-05-27 |