| NPI | 1942992177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A175736) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA 136439) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A175736) | |
| Enumeration Date | 2023-05-25 |
| Last Update Date | 2024-01-30 |