| NPI | 1104121508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-097253) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-097253) |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2024-02-01 |