| NPI | 1982467288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 37211) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 0000274212) |
| 363LF0000X Nurse Practitioner Family (Licence: KY 4027271) | |
| Enumeration Date | 2024-01-31 |
| Last Update Date | 2025-01-06 |