| NPI | 1053853184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MT 173392) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT 25804) |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2021-06-29 |