| NPI | 1114650850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 227422) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN147909) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA 227422) | |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2023-01-06 |