| NPI | 1912675976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5018997) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 277592) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 25406) | |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2023-11-21 |