| NPI | 1740955400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: DC 0024182369) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024182369) |
| Enumeration Date | 2021-08-13 |
| Last Update Date | 2022-08-03 |