| NPI | 1871046383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5017526) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 20221) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 9417) | |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2023-04-04 |