| NPI | 1053025510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 71325) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM RN-89764) |
| Enumeration Date | 2023-01-10 |
| Last Update Date | 2023-01-10 |