| NPI | 1689223943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A1566505) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 69598) |
| 363LF0000X Nurse Practitioner, Family (Licence: NE 112977) | |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-10-01 |