| NPI | 1760911366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL arnp9187209) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL ag02170124) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2020-10-11 |