| NPI | 1720586100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014447) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 21631) |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2021-06-22 |