| NPI | 1851050058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 196807) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 174737) |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2022-12-29 |