| NPI | 1336603570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC APN22099) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011766) |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2019-06-03 |