| NPI | 1770909517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 23040) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 208223) |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2022-11-01 |