| NPI | 1194408773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV 117436) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: VA 0001265005) |
| 363L00000X Nurse Practitioner (Licence: VA 0024187712) | |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2023-12-12 |