| NPI | 1073970794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5008355) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 19927) |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2022-05-21 |