| NPI | 1598417222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25861) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.010343) |
| Enumeration Date | 2022-01-24 |
| Last Update Date | 2022-06-14 |