| NPI | 1790167724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5013755) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 111826) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2023-10-14 |