| NPI | 1053623082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016466) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9289018) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11011347) | |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2022-12-20 |