| NPI | 1962015958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 61906) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11008838) |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2023-12-14 |