| NPI | 1053954511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-155851) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1155851) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-155851) | |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2023-06-30 |