| NPI | 1629697214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WI 10638) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OK R0116645) |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2024-05-09 |