| NPI | 1952712820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 23347) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 200664) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2023-02-03 |