| NPI | 1104579846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 11825) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A167346) |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2022-05-05 |