| NPI | 1679667661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11016944) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 198900) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2021-12-21 |