| NPI | 1932775863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MT 174855) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX 1030680) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2021-06-01 |