| NPI | 1780202580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25358) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 106009) |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2022-02-04 |