| NPI | 1790495430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD RN299478) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-133869) |
| Enumeration Date | 2022-12-05 |
| Last Update Date | 2022-12-05 |