| NPI | 1013560697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5013787) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO F07190504) |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2024-03-01 |