| NPI | 1073031902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21265) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: SC 4764) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2023-08-04 |