| NPI | 1700504776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A171375) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 68752) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN A171375) | |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2025-02-10 |