| NPI | 1164097630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: ND R41381) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-185885) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2021-08-13 |