| NPI | 1104581123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 77275) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 39558) |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2023-08-10 |