| NPI | 1942759329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009970) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174025) |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2019-11-04 |