| NPI | 1679107767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013392) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F02200395) |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2022-06-21 |