| NPI | 1770874570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 111250) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 111250) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2020-07-06 |