| NPI | 1073070512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22597) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 236740) |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2020-02-12 |