| NPI | 1649916529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 114317) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 56456) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A170136) | |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2022-08-04 |