| NPI | 1083126171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 72077) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 72077) |
| Enumeration Date | 2017-10-29 |
| Last Update Date | 2022-05-13 |