| NPI | 1790438877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24810) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180723) |
| Enumeration Date | 2022-01-30 |
| Last Update Date | 2024-01-16 |