| NPI | 1609413566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015615) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5015615) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 23528) | |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 251790) | |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2023-08-21 |