| NPI | 1720527997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-108782) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: AL 1-108782) |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2017-02-21 |