| NPI | 1649563164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 49696) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DE LG0000560) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2023-05-03 |