| NPI | 1083278600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 22559) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 8142) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2019-07-26 |