| NPI | 1740568443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-090748) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS R870697) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2020-05-18 |