| NPI | 1508264839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 6153) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 6153-33) |
| Enumeration Date | 2014-12-19 |
| Last Update Date | 2022-03-27 |