| NPI | 1699289355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024026918) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 370133) |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2024-08-13 |