| NPI | 1225644735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11014543) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179784) |
| Enumeration Date | 2020-09-20 |
| Last Update Date | 2021-08-30 |