| NPI | 1013564624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R36597) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 6936) |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2024-06-05 |