| NPI | 1174221824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 11024645) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WI 13074-33) |
| Enumeration Date | 2023-02-22 |
| Last Update Date | 2023-02-22 |