| NPI | 1578246062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SD CP002965) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A176122) |
| 163W00000X Registered Nurse (Licence: IA 151570) | |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2024-04-03 |