| NPI | 1740619550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5006591) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 500691) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2018-04-19 |