| NPI | 1316428618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 275050) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010890) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2019-01-24 |