| NPI | 1104345495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112332) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NE 1325) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2022-07-21 |