| NPI | 1396369138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 65132) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 51644) |
| Enumeration Date | 2020-06-06 |
| Last Update Date | 2022-02-09 |