| NPI | 1275009532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 54275) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM RN-78609) |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2019-09-18 |