| NPI | 1124772454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 11018117) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9406648) |
| Enumeration Date | 2022-02-06 |
| Last Update Date | 2022-07-12 |