| NPI | 1083278717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 1083278717) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: UT 5801043-3102) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2019-09-23 |