| NPI | 1790039998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-03460) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM R62373) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2022-01-24 |