| NPI | 1164182275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015583) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11016461) |
| Enumeration Date | 2021-12-30 |
| Last Update Date | 2022-07-12 |