| NPI | 1215511712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 10935) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 10935-33) |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2021-05-11 |