| NPI | 1861174492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NE 115803) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA A175735) |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2025-01-22 |