| NPI | 1780257691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014753) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC ANUKR8TRK) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2022-01-25 |