| NPI | 1164078796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WI 1215233) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VT 101.0134388) |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2023-06-26 |