| NPI | 1982392536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11026541) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9323634) |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2023-11-06 |