| NPI | 1891345567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11004110) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL F01191844) |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2019-09-18 |