| NPI | 1700419660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24216) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 201678) |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2023-08-08 |