| NPI | 1477105856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 11386447-8900) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MN 2275574) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-08-28 |