| NPI | 1194222539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22120) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 86088) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-08-08 |