| NPI | 1710556857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015481) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 223540) |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2021-12-29 |