| NPI | 1053845909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016038649) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO F09161352) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2021-02-11 |