| NPI | 1780169219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A155912) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 112640) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2019-10-16 |