| NPI | 1154969319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5012626) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NC 5012626) |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2020-03-12 |