| NPI | 1891273652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 59692) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018026389) |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2024-09-09 |