| NPI | 1164925343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MD AC003089) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024175605) |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2021-06-07 |