| NPI | 1205545159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 50178355) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 277741) |
| 363L00000X Nurse Practitioner (Licence: NC TIGL-67B7D) | |
| Enumeration Date | 2022-11-18 |
| Last Update Date | 2023-04-06 |