| NPI | 1629629852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL F09191047) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-143463) |
| Enumeration Date | 2019-09-29 |
| Last Update Date | 2020-03-10 |