| NPI | 1720473390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 9690147-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK 1529) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2021-08-12 |