| NPI | 1548793623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012918) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174734) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2020-03-17 |