| NPI | 1407413339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 218115) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11007499) |
| Enumeration Date | 2019-05-27 |
| Last Update Date | 2021-09-07 |