| NPI | 1780302075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016776) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC FLEM2AQ5Q) |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2022-08-23 |