| NPI | 1750039681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R17610) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R17610) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ 287130) | |
| Enumeration Date | 2022-03-10 |
| Last Update Date | 2024-01-04 |