| NPI | 1922300904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5004978) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5004978) |
| Enumeration Date | 2010-11-24 |
| Last Update Date | 2022-01-20 |