| NPI | 1154955755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 211748) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA 211748) |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2022-05-10 |