| NPI | 1053069187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5016281) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F03220095) |
| 163W00000X Registered Nurse (Licence: NC 237151) | |
| Enumeration Date | 2022-03-17 |
| Last Update Date | 2022-08-08 |