| NPI | 1942824768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC TISD-7K5PK) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 270439) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2023-02-06 |