| NPI | 1417436700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP10062) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 10062) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2022-01-27 |