| NPI | 1053893768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP019453) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA Pending) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2018-11-19 |