| NPI | 1619396272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11013506) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006852) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2024-03-16 |