| NPI | 1568968493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A149805) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 2030) |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2022-10-27 |