| NPI | 1770197022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5013578) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 239958) |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2021-04-20 |