| NPI | 1891123345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 18511) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 200652) |
| Enumeration Date | 2013-10-18 |
| Last Update Date | 2020-10-08 |