| NPI | 1154991917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014631) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 93547) |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2021-07-19 |