| NPI | 1770934671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A124978) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A124978) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2021-04-06 |