| NPI | 1104590298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 3-000644) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11011360) |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2022-05-02 |