| NPI | 1285107318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 202029) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 902999) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA 299338) | |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2021-05-20 |