| NPI | 1669013777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5012057) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 5012057) |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2020-06-11 |