| NPI | 1003275199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011662) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP1292862) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2023-02-02 |