| NPI | 1710194311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 2811112) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN2811112) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-09-13 |