| NPI | 1760832943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP08802) |
| 363LF0000X Nurse Practitioner Family (Licence: LA AP08802) | |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2020-05-27 |