| NPI | 1053980383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11013724) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 300313) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11013724) | |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2024-01-02 |