| NPI | 1073229621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11024006) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA CNP-COND2325479) |
| Enumeration Date | 2023-01-26 |
| Last Update Date | 2024-02-06 |