| NPI | 1639821010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015521) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 270638) |
| Enumeration Date | 2022-01-26 |
| Last Update Date | 2022-04-18 |