| NPI | 1790413136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: UT 7294790-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 7294790-3102) |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2022-12-11 |