| NPI | 1093360166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11004138) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9301517) |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2019-10-03 |