| NPI | 1316318298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008136) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 256120) |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2021-05-11 |