| NPI | 1245907104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC ATKI-JC05A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014949) |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2021-08-27 |