| NPI | 1003209602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 0) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28184875A) |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2021-01-28 |