| NPI | 1770945263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10001428) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 6843-33) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2024-09-05 |