| NPI | 1962102996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS 905846) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX 1130569) |
| Enumeration Date | 2023-03-08 |
| Last Update Date | 2023-09-14 |