| NPI | 1063063642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22435) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 204882) |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2022-11-03 |