| NPI | 1811586522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 113494) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 2204) |
| Enumeration Date | 2021-01-16 |
| Last Update Date | 2021-07-06 |