| NPI | 1407463599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 113391) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 77986) |
| 363LF0000X Nurse Practitioner, Family (Licence: NE 77986) | |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2023-09-10 |