| NPI | 1144636192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22754) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 22754) |
| 163W00000X Registered Nurse (Licence: SC 221100) | |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2020-03-11 |