| NPI | 1992253090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-110947) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 901772) |
| Enumeration Date | 2016-09-17 |
| Last Update Date | 2019-06-21 |