| NPI | 1114568870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA a168677) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: IA 140534) |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2022-08-15 |