| NPI | 1023538030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 21044) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 21044) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2020-11-09 |