| NPI | 1730741208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 56879) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM RN-87926) |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2020-04-29 |