| NPI | 1174172266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11004015) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11004015) |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2022-12-19 |