| NPI | 1548765563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21840) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010366) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2022-05-03 |