| NPI | 1790374536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 10012360) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CT 9403) |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2023-10-27 |