| NPI | 1023602190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 219019) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN152828) |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2021-04-01 |