| NPI | 1700622966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 29253) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024190646) |
| 163W00000X Registered Nurse (Licence: VA 0001280975) | |
| Enumeration Date | 2024-07-06 |
| Last Update Date | 2024-08-26 |