| NPI | 1104480862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011731) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5011731) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2022-03-16 |