| NPI | 1225687759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 62729) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID F09190260) |
| Enumeration Date | 2019-09-07 |
| Last Update Date | 2024-05-01 |