| NPI | 1417628058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11029574) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 10051) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2024-01-02 |