| NPI | 1811669567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV 110763) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP027992) |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2023-08-16 |