| NPI | 1710591946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 24288) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 227277) |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2022-03-28 |