| NPI | 1174007561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 53843) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 250792) |
| Enumeration Date | 2018-09-20 |
| Last Update Date | 2021-01-05 |