| NPI | 1649933953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25553) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 101952) |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2021-11-02 |