| NPI | 1164096632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014515) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 24460) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2021-11-19 |