| NPI | 1073279816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 14487) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 263658) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 14487) | |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2024-01-09 |