| NPI | 1962190090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 212045) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN224536) |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2024-01-19 |