| NPI | 1073993457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 10154) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 194001) |
| 363L00000X Nurse Practitioner (Licence: WI 10154) | |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2022-10-06 |