| NPI | 1518508506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 62839) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201908773NP-PP) |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2024-05-03 |