| NPI | 1164192290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A165853) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 127928) |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2021-10-12 |