| NPI | 1821634205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 113052) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE Pending) |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2020-08-20 |