| NPI | 1649794561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25345) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A123583) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2023-09-11 |