| NPI | 1700495553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5013412) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 26418) |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2023-11-15 |