| NPI | 1871058834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: LA 203786) |
| Additional Taxonomies | 163WE0003X Registered Nurse Emergency (Licence: LA RN127060) |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2019-03-13 |