| NPI | 1982203493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 113361) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A163332) |
| 363LF0000X Nurse Practitioner, Family (Licence: NE 113361) | |
| 363L00000X Nurse Practitioner (Licence: IA A163332) | |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2021-06-24 |