| NPI | 1912547803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 23724) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 221115) |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2022-11-02 |