| NPI | 1558921429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 61268) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 11450495-4405) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2020-01-29 |