| NPI | 1417617168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016419) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F12210012) |
| Enumeration Date | 2021-12-22 |
| Last Update Date | 2022-10-25 |