| NPI | 1114639192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017397) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 216622) |
| 363L00000X Nurse Practitioner (Licence: NC 5017397) | |
| Enumeration Date | 2022-12-21 |
| Last Update Date | 2025-01-23 |