| NPI | 1497004774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201905493NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 201905493NP) |
| Enumeration Date | 2012-09-03 |
| Last Update Date | 2024-03-26 |