| NPI | 1962948075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AR A004969) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AR A004969) |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2019-09-18 |