| NPI | 1518667328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 76635) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11024841) |
| Enumeration Date | 2023-03-09 |
| Last Update Date | 2024-10-08 |