| NPI | 1013566595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ID CNP62185) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 48826) |
| Enumeration Date | 2019-09-08 |
| Last Update Date | 2019-09-08 |