| NPI | 1245858984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25736) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 235622) |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2022-05-19 |