| NPI | 1154974988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN293905) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024177260) |
| Enumeration Date | 2019-07-21 |
| Last Update Date | 2022-05-11 |