| NPI | 1568972842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21185) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC F07171075) |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2019-11-05 |