| NPI | 1740883495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022022412) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 250088) |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2023-03-15 |