| NPI | 1376107672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-116053) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-116053) |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2020-04-02 |