| NPI | 1366848210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 17917) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 100246) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2023-12-28 |