| NPI | 1639524325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11022755) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 0992346) |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2022-12-01 |