| NPI | 1558020289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A166773) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA 117463) |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2023-07-02 |