| NPI | 1568114650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25734) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017456) |
| 363L00000X Nurse Practitioner (Licence: SC 25734) | |
| 363L00000X Nurse Practitioner (Licence: NC 5017456) | |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2024-04-03 |