| NPI | 1265995138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22583) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD 22583) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2022-11-02 |