| NPI | 1063971083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22467) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 22467) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 22647) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2021-05-25 |