| NPI | 1750798013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007804) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18940) |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2024-09-13 |