| NPI | 1639841802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015173) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC LINE-K260F) |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2021-11-19 |