| NPI | 1184197311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 64875) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: ID 38220) |
| 363L00000X Nurse Practitioner (Licence: ID 64875) | |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2021-02-05 |