| NPI | 1912735069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP030421) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA RN671056) |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-08-22 |