| NPI | 1972254803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 114065) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 81073) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A181971) | |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2025-02-19 |