| NPI | 1275048894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021039843) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010090) |
| 363LF0000X Nurse Practitioner, Family (Licence: AR A005241) | |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2022-07-01 |