| NPI | 1982479069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5019855) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC HERG-6GVXT) |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2024-07-15 |