| NPI | 1790172070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 26155) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 6321-33) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2024-09-09 |