| NPI | 1093323461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS BOON-63OKMA) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 28110) |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2022-08-02 |