| NPI | 1871106179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 10008) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014789) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79632-032) | |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2023-11-29 |