| NPI | 1124548177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2023010325) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2017020562) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2023-10-30 |