| NPI | 1700402419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 214913) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN137670) |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-12-20 |