| NPI | 1770628281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19086) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28144568A) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2021-05-26 |