| NPI | 1962005157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11024300) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9547860) |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2023-02-21 |