| NPI | 1083207906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: AL 1-111425) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AL 1-111425) |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2021-02-12 |