| NPI | 1639833783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0997039) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0997039) |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2022-03-25 |