| NPI | 1952676991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM cnp00520) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM cnp00520) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2021-03-29 |