| NPI | 1053662171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-049268) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: AL 1-049268) |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2022-01-31 |