| NPI | 1790295400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 902295) |
| Additional Taxonomies | 363LS0200X Nurse Practitioner, School (Licence: MS 902295) |
| Enumeration Date | 2017-10-07 |
| Last Update Date | 2017-10-07 |