| NPI | 1790336964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5012351) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC F06192515) |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2022-04-25 |