| NPI | 1366107872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5020430) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 216410) |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2024-10-30 |