| NPI | 1356807721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011478) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC CAME-PF4PU9) |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2019-12-23 |