| NPI | 1639239288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013979) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 3157) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-07-12 |