| NPI | 1639795891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24755) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014414) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2023-09-10 |