| NPI | 1225792021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 74807) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 51024) |
| Enumeration Date | 2021-10-27 |
| Last Update Date | 2023-02-20 |