| NPI | 1962174953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ID 55734) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: ID 00000) |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2022-04-26 |