| NPI | 1104469329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112919) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A157004) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2019-12-16 |