| NPI | 1770102329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 202002630NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 27371) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2021-08-09 |