| NPI | 1114635943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5017500) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC PERS-EBM3W) |
| Enumeration Date | 2022-11-10 |
| Last Update Date | 2024-11-22 |