| NPI | 1669015061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112993) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 112993) |
| Enumeration Date | 2019-10-18 |
| Last Update Date | 2019-12-23 |