| NPI | 1063000164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014796) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC AMED-9HUTU) |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2024-01-24 |