| NPI | 1194282061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R242201) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5011514) |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2020-06-26 |