| NPI | 1790130664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP08634) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: LA AP08634) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2019-02-11 |