| NPI | 1942626098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 276761) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP013734) |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2018-03-15 |