| NPI | 1063170843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-163300) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-163300) |
| Enumeration Date | 2021-11-29 |
| Last Update Date | 2024-03-12 |