| NPI | 1982940417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014918) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9266476) |
| Enumeration Date | 2013-01-03 |
| Last Update Date | 2023-05-12 |