| NPI | 1790193993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 5905) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 16711) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2019-10-04 |