| NPI | 1962054452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 23052) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 23052) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 23032) | |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2020-09-11 |