| NPI | 1790450773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 221829) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 904652) |
| Enumeration Date | 2021-08-12 |
| Last Update Date | 2023-02-21 |