| NPI | 1336621713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 9668) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 8303066-4405) |
| Enumeration Date | 2018-09-03 |
| Last Update Date | 2021-12-21 |