| NPI | 1114667532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 114325) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 60315) |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2022-08-04 |