| NPI | 1104644954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11035625) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9540840) |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-10-01 |