| NPI | 1679265573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 28297) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 243350) |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2024-02-13 |