| NPI | 1700460276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014629) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 328715) |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2021-07-20 |