| NPI | 1700262664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000974) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD 0000) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2022-04-22 |