| NPI | 1861162943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 113773) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 11427) |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2023-02-14 |