| NPI | 1154873644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 11018718) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: WI 16-662) |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2024-01-19 |