| NPI | 1689225534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9174553) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170483) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2019-09-23 |