| NPI | 1376105544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL F06192197) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: FL RN9330896) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2019-10-12 |