| NPI | 1114623303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 27212) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017554) |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2023-05-11 |