| NPI | 1679027361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A119686) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 119686) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A119686) | |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2023-08-29 |