| NPI | 1114587698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 208846) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 208846) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2020-09-15 |