| NPI | 1740924802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 25695) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC F08210575) |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2022-04-28 |