| NPI | 1700404084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014059) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F06200958) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5014059) | |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2021-02-18 |