| NPI | 1063196707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 114885) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 84719) |
| Enumeration Date | 2023-06-13 |
| Last Update Date | 2023-09-01 |