| NPI | 1861158420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5015359) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 188323) |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2022-03-02 |