| NPI | 1336334234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11026042) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 139210) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 138210) | |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2023-06-07 |