| NPI | 1831740760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112878) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 82107) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2019-09-23 |