| NPI | 1790444081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11020950) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PR 72635) |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2023-02-24 |