| NPI | 1902340813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA 2016015030) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA sp016622) |
| Enumeration Date | 2016-12-12 |
| Last Update Date | 2018-12-18 |