| NPI | 1548618747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201907060) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 103201) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2023-10-23 |