| NPI | 1790102044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25364) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: SC 211333) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2022-10-13 |