| NPI | 1649262288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 1983) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 201971) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2022-11-08 |