| NPI | 1750643169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009866) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 231912) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2021-07-15 |