| NPI | 1053954248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AL 1-066695) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: AL 1-066695) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2020-10-02 |