| NPI | 1619751641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: LA 234539) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN158794) |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2024-11-16 |