| NPI | 1740894690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11014129) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA F06192611) |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2022-01-04 |