| NPI | 1720333966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 208336) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: LA RN106419) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2021-04-05 |