| NPI | 1316592629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112980) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE F05190873) |
| 363LF0000X Nurse Practitioner, Family (Licence: HI F05190873) | |
| Enumeration Date | 2019-08-04 |
| Last Update Date | 2019-10-12 |