| NPI | 1629526231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 20452) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 20452) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2020-12-02 |