| NPI | 1073144853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11007555) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9302074) |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2020-06-15 |