| NPI | 1801403068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11009188) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 10580) |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2023-06-14 |