| NPI | 1760155501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 64624) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 64624) |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2021-08-16 |