| NPI | 1871101659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11008878) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9462385) |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2021-05-05 |