| NPI | 1578321816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 15149) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 15149-33) |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2024-08-23 |