| NPI | 1639637358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014461) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 22694) |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2021-09-27 |