| NPI | 1770104705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11020409) |
| Additional Taxonomies | 251B00000X Case Management (Licence: FL 100519) |
| 163W00000X Registered Nurse (Licence: FL 9526021) | |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2022-07-13 |