| NPI | 1639554520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 1639554520) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9289347) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2024-09-13 |