| NPI | 1811540677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012095) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018043386) |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2024-02-29 |