| NPI | 1790140283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5016447) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9362937) |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2022-09-19 |