| NPI | 1982329942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 13502) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 152998) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 13502-33) | |
| Enumeration Date | 2022-10-11 |
| Last Update Date | 2023-07-19 |