| NPI | 1972197929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A160930) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 119876) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA F09201251) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A160930) | |
| Enumeration Date | 2021-02-21 |
| Last Update Date | 2022-02-23 |