| NPI | 1922626068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 12115763-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA F07200442) |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2021-03-12 |