| NPI | 1740685361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA a102274) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 102274) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2019-12-13 |