| NPI | 1902968779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 201304) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 135188) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2022-06-15 |