| NPI | 1164044608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11011185) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179226) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2021-08-20 |