| NPI | 1235917311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5019033) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC PLOT-TMT12) |
| Enumeration Date | 2023-09-19 |
| Last Update Date | 2024-01-08 |