| NPI | 1104551225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: LA 225025) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 225028) |
| Enumeration Date | 2022-07-21 |
| Last Update Date | 2023-10-04 |