| NPI | 1205566940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2022019370) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 199060) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2022-06-27 |