| NPI | 1679080055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19894) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 2015021806) |
| Enumeration Date | 2018-01-06 |
| Last Update Date | 2022-07-21 |