| NPI | 1710562517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 113535) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 75242) |
| Enumeration Date | 2021-03-12 |
| Last Update Date | 2022-07-14 |