| NPI | 1679234413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11017537) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 12210805) |
| Enumeration Date | 2022-01-04 |
| Last Update Date | 2022-01-28 |