| NPI | 1457700734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 901643) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 138762) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 21554) | |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2022-07-21 |