| NPI | 1073974168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND F07201054) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ND R34926) |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2020-08-04 |