| NPI | 1477094480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009353) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176128) |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2021-03-22 |