| NPI | 1558428458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 105094) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 19254) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2024-01-02 |