| NPI | 1700404779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AK 135795) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: AK 133039) |
| 363L00000X Nurse Practitioner (Licence: AK 162225) | |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2022-08-31 |