| NPI | 1912451998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201905666NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8434) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2021-04-28 |