| NPI | 1275285397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5018347) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC F06231720) |
| 363LF0000X Nurse Practitioner Family (Licence: NC 5018347) | |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2023-10-16 |