| NPI | 1902441082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC PRIE-0IZWP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 228463) |
| 163W00000X Registered Nurse (Licence: NC 278242) | |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2021-10-28 |