| NPI | 1780092130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 60782) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 7323824-4405) |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2023-08-22 |