| NPI | 1376008672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 203821) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: LA 122384) |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2019-12-02 |