| NPI | 1992253140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 21755) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024174242) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2024-06-05 |