| NPI | 1417352436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 23209) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: SC 226103) |
| Enumeration Date | 2014-11-03 |
| Last Update Date | 2019-09-11 |