| NPI | 1164016507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CO 0996159) |
| Additional Taxonomies | 225000000X Orthotic Fitter (Licence: CO 0996159) |
| Enumeration Date | 2021-02-25 |
| Last Update Date | 2023-07-31 |