| NPI | 1154810596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 260633) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 78097) |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2021-09-14 |