| NPI | 1356820476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 856533) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 220277) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2020-10-07 |