| NPI | 1215352604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5012585) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171541) |
| Enumeration Date | 2014-02-21 |
| Last Update Date | 2021-08-21 |