| NPI | 1639245392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 18969) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP008719) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2021-05-17 |