| NPI | 1164972790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 196744) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5008851) |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2024-08-02 |