| NPI | 1063037661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024189777) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95219708) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95027850) | |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2024-08-06 |