| NPI | 1053049403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0997887) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 307831) |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2024-06-18 |