| NPI | 1376124883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5015163) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NC 5015163) |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2024-02-19 |