| NPI | 1760025639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP62991) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID CNP62991) |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2021-03-17 |