| NPI | 1366852345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22264) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 100813) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2022-03-30 |