| NPI | 1770018095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011708) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 20898) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2020-09-08 |