| NPI | 1770113441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 215880) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 903712) |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-10-12 |