| NPI | 1619523123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A155684) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IA A155684) |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2022-01-06 |