| NPI | 1952716813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5013646) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9253753) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2021-04-30 |