| NPI | 1518319623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 20329) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 29172) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2021-03-16 |