| NPI | 1407374754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 204668) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP018169) |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2019-08-01 |