| NPI | 1770217796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 114314) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A170201) |
| 163W00000X Registered Nurse (Licence: NE 75590) | |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-08-15 |