| NPI | 1194317412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014190) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 205313) |
| 363L00000X Nurse Practitioner (Licence: NC 5014190) | |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2022-08-31 |