| NPI | 1770045932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP021900) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO APN.0994577-NP) |
| 363L00000X Nurse Practitioner (Licence: FL APRN11001954) | |
| 363L00000X Nurse Practitioner (Licence: WA AP61028192) | |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2020-05-19 |