| NPI | 1144863101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 222685) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN154308) |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2022-01-13 |