| NPI | 1164206447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5018658) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5018658) |
| Enumeration Date | 2023-08-18 |
| Last Update Date | 2024-09-19 |