| NPI | 1649677030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007354) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5007354) |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2022-10-05 |