| NPI | 1215607155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015062) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC F09210581) |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2023-01-10 |