| NPI | 1609279488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014517) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 238281) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2022-01-14 |