| NPI | 1962031393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0995958) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 1667826) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2024-06-26 |