| NPI | 1053902270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017105) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 301676) |
| Enumeration Date | 2021-01-30 |
| Last Update Date | 2022-11-28 |