| NPI | 1972150225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A180341) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A180341) |
| 363L00000X Nurse Practitioner (Licence: WI 9525) | |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2024-08-30 |