| NPI | 1831386960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5006729) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0017138820) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024167293) | |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2023-03-07 |