| NPI | 1720658255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC GADD-JIR1B) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5014890) |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2024-10-23 |