| NPI | 1902525330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A170851) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 138062) |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2022-09-14 |