| NPI | 1801171889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024175881) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CO 990254) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2018-03-17 |