| NPI | 1760124747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 114300) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A169841) |
| 163W00000X Registered Nurse (Licence: NE 89401) | |
| Enumeration Date | 2022-04-11 |
| Last Update Date | 2022-07-26 |