| NPI | 1790528289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2024027175) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2004005156) |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-07-28 |