| NPI | 1700983756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014153) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NC L002426) |
| 163W00000X Registered Nurse (Licence: NC 234894) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-05-13 |