| NPI | 1174163794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11004882) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95024117) |
| Enumeration Date | 2020-01-11 |
| Last Update Date | 2025-02-25 |