| NPI | 1457987448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11007554) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9383308) |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2020-08-07 |