| NPI | 1265049811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 90210024405) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: UT 9021002-3102) |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2021-10-11 |