| NPI | 1639489966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010656) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT 25360) |
| 363LF0000X Nurse Practitioner, Family (Licence: MT 25360) | |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2022-09-29 |