| NPI | 1174017701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ID 58914) |
| Additional Taxonomies | 163WW0000X Registered Nurse Wound Care (Licence: ID 58914) |
| 207Q00000X Family Medicine (Licence: ID 58914) | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2020-07-24 |