| NPI | 1942258165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9494810) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NV APN000840) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 578486) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2024-10-29 |