| NPI | 1720683402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 66271) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 202010275NP-PP) |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2025-01-07 |