| NPI | 1053955005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A156991) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A156991) |
| 363LX0106X Nurse Practitioner, Occupational Health (Licence: IA A156991) | |
| Enumeration Date | 2019-11-03 |
| Last Update Date | 2019-11-03 |