| NPI | 1164907978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-160072) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: AL 1-160072) |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2018-12-12 |