| NPI | 1659043412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25812) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016539) |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2023-08-31 |