| NPI | 1700545209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 71537) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 51885) |
| Enumeration Date | 2021-12-12 |
| Last Update Date | 2022-02-02 |