| NPI | 1942755343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5012639) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 7072) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2023-01-11 |