| NPI | 1760137277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 235870) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 906781) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95223265) | |
| Enumeration Date | 2022-02-14 |
| Last Update Date | 2024-09-18 |