| NPI | 1942618624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112161) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95001030) |
| Enumeration Date | 2014-07-26 |
| Last Update Date | 2019-11-07 |