| NPI | 1730690397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 23109) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC STEH2C) |
| 363L00000X Nurse Practitioner (Licence: NC 5010054) | |
| 363LF0000X Nurse Practitioner Family (Licence: NC 5010054) | |
| Enumeration Date | 2017-10-22 |
| Last Update Date | 2022-04-13 |