| NPI | 1861116295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R196741) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R196741) |
| Enumeration Date | 2022-09-29 |
| Last Update Date | 2023-01-04 |