| NPI | 1902354145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 236814) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 2016014899) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2020-02-24 |