| NPI | 1720406960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 115291) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 0995674) |
| 163W00000X Registered Nurse (Licence: CO 0173599) | |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2024-09-20 |