| NPI | 1194509711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11024192) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9434346) |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2023-08-23 |