| NPI | 1932511839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11012542) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: MA R.M.A 217709) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2021-05-10 |