| NPI | 1356968416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1102615) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 1-102815) |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2021-08-20 |