| NPI | 1710539820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112941) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: NE 76925) |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2019-10-29 |