| NPI | 1003459132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A180897) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019031435) |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2024-10-21 |