| NPI | 1164052262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MD AC003342) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024178704) |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2022-06-07 |