| NPI | 1639787054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 65439) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11008163) |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2023-09-11 |