| NPI | 1942773783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011329) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5011329) |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2019-02-15 |