| NPI | 1891242004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 6695) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 110394) |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2022-09-29 |