| NPI | 1174243752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD 002530) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD F08220646) |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2022-09-30 |