| NPI | 1376929547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11010021) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11010021) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4074) | |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2020-12-31 |