| NPI | 1114647179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 114343) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NE 114343) |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2022-10-14 |