| NPI | 1902394067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010560) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 303827) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2020-06-10 |