| NPI | 1700351830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 6320538-4405) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: UT 6320538-3102) |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2018-11-02 |