| NPI | 1629858659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 14605-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A172729) |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2024-10-02 |