| NPI | 1063171270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015559) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 223461) |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2021-12-31 |