| NPI | 1932666252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR 215603) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 887494) |
| 363LF0000X Nurse Practitioner, Family (Licence: MS 904183) | |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2021-07-20 |