| NPI | 1902199441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 143865) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN204073) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2019-07-19 |