| NPI | 1053940882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014738) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178537) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2023-01-11 |