| NPI | 1649923855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017062) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 252641) |
| Enumeration Date | 2022-01-28 |
| Last Update Date | 2022-11-09 |