| NPI | 1972014520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9309077) |
| Additional Taxonomies | 163WA2000X Registered Nurse Administrator (Licence: FL RN9309077) |
| Enumeration Date | 2017-10-22 |
| Last Update Date | 2018-02-13 |