| NPI | 1679293815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017096) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 2022026211) |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2022-10-24 |