| NPI | 1720754807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202112422NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016516) |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2021-11-11 |