| NPI | 1811434574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IN F05240235) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: IN 36002320A) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2024-05-15 |