| NPI | 1548761000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21615) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 222331) |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2019-02-28 |