| NPI | 1902495138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 27647) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5014514) |
| 363LF0000X Nurse Practitioner Family (Licence: NC F1100896) | |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2023-09-20 |