| NPI | 1780150979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 61016) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 42111) |
| Enumeration Date | 2018-10-16 |
| Last Update Date | 2019-03-21 |