| NPI | 1073974192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9434969) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 21055) |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2023-04-05 |