| NPI | 1780211342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5013224) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 27305) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2020-11-07 |