| NPI | 1215485503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP61270) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID RN61270) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2024-04-17 |