| NPI | 1710440722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011789) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC S0MZF4) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2022-08-04 |