| NPI | 1609390814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010278) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 22908) |
| Enumeration Date | 2017-07-29 |
| Last Update Date | 2020-02-17 |