| NPI | 1790067791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202113856NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 16088) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2022-02-22 |