| NPI | 1629445937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A141466) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 112994) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2019-12-16 |