| NPI | 1619505260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 23815) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 23815) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2022-03-02 |