| NPI | 1912477902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22486) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 226098) |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2019-03-12 |