| NPI | 1912591280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5014242) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 278541) |
| 363L00000X Nurse Practitioner (Licence: NC 5014242) | |
| Enumeration Date | 2021-02-26 |
| Last Update Date | 2024-07-19 |