| NPI | 1083278790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112830) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 77902) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2019-06-18 |