| NPI | 1235764317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015436) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001251414) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179815) | |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2021-12-20 |