| NPI | 1811774888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 11030234) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9596679) |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2024-05-28 |