| NPI | 1316559073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 68388) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 071833623) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2337812) | |
| Enumeration Date | 2020-08-23 |
| Last Update Date | 2021-09-15 |