| NPI | 1013515667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 904178) |
| Additional Taxonomies | 208800000X Urology (Licence: MS 1508886805) |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2021-10-05 |