| NPI | 1720586001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21507) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC F12170147) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2018-02-01 |