| NPI | 1811598261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-147135) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-147135) |
| 363LF0000X Nurse Practitioner, Family (Licence: AL 0) | |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2021-12-23 |