| NPI | 1053070680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 28057) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 235016) |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2024-06-12 |