| NPI | 1588217863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11004120) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP026831) |
| 363LF0000X Nurse Practitioner Family (Licence: MD AC00004816) | |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2025-04-23 |