| NPI | 1790027464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22230) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 213514) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2019-12-18 |