| NPI | 1821650102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5020269) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 9334-33) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2024-08-08 |