| NPI | 1972048379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 114469) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 52426) |
| Enumeration Date | 2016-12-21 |
| Last Update Date | 2022-12-18 |