| NPI | 1063850246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 5653) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 2011003580) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2022-11-11 |