| NPI | 1750152260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 53788) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 10025099) |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2024-12-10 |