| NPI | 1912669896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11015934) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9473852) |
| Enumeration Date | 2021-10-08 |
| Last Update Date | 2021-10-13 |