| NPI | 1104457738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11015254) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9488788) |
| Enumeration Date | 2020-02-02 |
| Last Update Date | 2022-01-13 |