| NPI | 1639705338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 904892) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 891114) |
| Enumeration Date | 2020-03-13 |
| Last Update Date | 2022-06-30 |