| NPI | 1174092134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11014464) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176926) |
| 207Q00000X Family Medicine (Licence: VA 0024176926) | |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2021-08-19 |