| NPI | 1609401058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP025441) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001203718) |
| 363L00000X Nurse Practitioner (Licence: VA 0024179423) | |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2022-10-21 |