| NPI | 1063178622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015740) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC BUMG-XQH6C) |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2022-03-03 |