| NPI | 1972987949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 5680387-8900) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 5680387-3102) |
| Enumeration Date | 2015-07-19 |
| Last Update Date | 2021-09-16 |