| NPI | 1811717564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A181855) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 155342) |
| Enumeration Date | 2024-10-16 |
| Last Update Date | 2024-12-06 |