| NPI | 1134866825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5016510) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 204207) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5016510) | |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2024-08-02 |