| NPI | 1194418079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 28484) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 243089) |
| Enumeration Date | 2023-05-29 |
| Last Update Date | 2024-04-08 |