| NPI | 1356922702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017333) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-164576) |
| Enumeration Date | 2021-04-17 |
| Last Update Date | 2023-01-15 |