| NPI | 1902489164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA 11111111) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A163397) |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2021-05-04 |