| NPI | 1942064456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5020086) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 271115) |
| Enumeration Date | 2024-02-06 |
| Last Update Date | 2024-05-17 |