| NPI | 1689174310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 11013195) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704265247NSA18163) |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2022-07-14 |