| NPI | 1417565912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 3-001616) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 27804) |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2024-05-07 |