| NPI | 1790378123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016804) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP023110) |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2022-09-07 |