| NPI | 1750902052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112969) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A158598) |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2020-04-29 |