| NPI | 1790404879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016875) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 348572) |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2024-01-25 |