| NPI | 1700545753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015522) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC GWAL-J8F9N) |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2021-12-29 |