| NPI | 1891211967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A123651) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 5335) |
| Enumeration Date | 2017-08-20 |
| Last Update Date | 2021-03-15 |