| NPI | 1255947974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24467) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC AG03200068) |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-11-30 |