| NPI | 1568020105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 9346) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 223695) |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2020-10-20 |