| NPI | 1679059463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 30072) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010909) |
| Enumeration Date | 2018-07-14 |
| Last Update Date | 2022-08-30 |